Organization
MARSHALL PEDIATRIC THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAM MARSHALL OT (OCCUPATIONAL THERAPIST / OWNER)
(859) 224-2273
Entity
Organization
Contact information
Practice address
109 WIND HAVEN DR STE 100, NICHOLASVILLE, KY 40356-8010
(859) 224-2273
(859) 224-4675
Mailing address
109 WIND HAVEN DR STE 100, NICHOLASVILLE, KY 40356-8010
(859) 224-2273
(859) 224-4675
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
1196
KY
225100000X
Physical Therapist
5326
KY
225X00000X
Occupational Therapist
—
—
225XP0019X
Physical Rehabilitation Occupational Therapist
—
—
225XP0200X
Pediatric Occupational Therapist
Primary
R3083
KY
235Z00000X
Speech-Language Pathologist
4077
KY
251S00000X
Community/Behavioral Health Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100205670
—
KY
05
—
7100215800
—
KY
05
—
7100275720
—
KY
05
—
7100278210
—
KY
05
—
7100299670
—
KY
05
—
7100328480
—
KY
05
—
7101016200
—
KY
Enumeration date
02/02/2012
Last updated
02/25/2025
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